Elevated pulmonary arterial elastance and right ventricular uncoupling are associated with greater mortality in advanced heart failure
To describe right ventricular-pulmonary arterial elastance coupling hemodynamic phenotypes and their frequency in patients with advanced heart failure. Further, to evaluate the association of elastance-based indices with all-cause mortality, cardiac transplantation, and left ventricular assist device therapy.
In the era of increased left ventricular support device (LVAD) implantation, limited data is available on outcomes in the obese population, with most available data describing elevated BMI with a cutoff of>30 kg/m2. Forest et al examined the ISHLT Mechanically Assisted Circulatory Support (IMACS) registry and found no impact in 2-year mortality in those with higher BMIs, but an increase in all adverse events describing BMI> 40 kg/m2 group. We seek to provide our experience with this population.
The objectives of this study were to describe survival, characterize rates of adverse events (AEs) and compare survival after an AE in patients age ≥70 vs. age 50-69.
Amyloid transthyretin (ATTR) cardiac amyloidosis (CA) is an increasingly recognized cause of restrictive cardiomyopathy and associated heart failure with preserved ejection fraction (HFpEF). Despite improved diagnostic techniques to identify this condition, many patients experience delayed diagnosis. Interpretation of routine cardiac biomarkers (i.e. troponins and brain natriuretic peptide (BNP)) and echocardiography in ATTR-CA is limited, particularly in relation to pyrophosphate (PYP) scintigraphy.
Patients with heart failure (HF) requiring advanced therapies (AT) or palliative inotropes have been well described in the literature, but less is known regarding their earlier clinical course. Patients started on inotropes may be appropriate candidates for AT, yet do not always receive timely evaluations. Given the high mortality associated with end stage HF, we investigated the clinical characteristics and outcomes of HF patients after initiation of inotrope therapy.
Exercise tolerance has important prognostic value in patients with heart failure and reduced ejection fraction (HFrEF). The relationship between right ventricular function and its coupling to pulmonary circulation (RV-PA) and cardiopulmonary exercise tests (CPET) is not fully understood. We aimed to evaluate the value of RV echocardiographic parameters, including RV-PA, to predict exercise tolerance in HFrEF patients.
We examined the association between MAGGIC predicted prognosis and actual outcomes, in order to assess predictive performance of the score and determine a threshold for identifying patients at risk.
We hypothesized that a novel invasive hemodynamic measure reflecting cardiac contractility and filling pressure would predict long-term prognosis.
Heart transplantation (HT) and mechanical circulatory support (MCS) has improved heart failure (HF) patient (PT) outcomes; it has also led to increased caregiver (CG) responsibility pre and post-surgery. We assessed whether PT and CG factors were related to baseline CG perceived burden in 3 groups of CGs of HF PTs (60-80 years): (1) PT supported with MCS as a bridge to HT (HT BTT), (2) PT awaiting HT without MCS (HT non BTT), and (3) PT prior to MCS for destination therapy (DT MCS).
Carbohydrate antigen 125 (CA125), a marker for ovarian cancer, is thought to be associated with the clinical severity of heart failure (HF) and fluid congestion. Mesothelial cells in the pericardium, pleura, peritoneum and M ¨ullerian epithelium produce CA125 presumably in response to mechanical (congestion) stress. With the growing use of left ventricular assist device (LVAD) for advanced HF, assessment of right ventricular (RV) function and hemodynamics is of major interest. We aimed to assess CA125 as a predictor of right heart function and hemodynamics.
Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by organized thrombi in the pulmonary arteries leading to right heart failure and death. Impaired angiogenesis and systemic inflammation could be involved in the pathophysiology of this disease. The aim of this study was to determine the angiogenic expression profile in patients with CTEPH.